Are you sure you want to exit? Your progress will be lost.
Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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I acknowledge and authorize
✔
I consent to the collection of my consumer health data.*
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I consent to the sharing of my consumer health data with qualified home care agencies.*
*If I am consenting on behalf of someone else, I have the proper authorization to do so. By clicking Get My Results, you agree to our Privacy Policy. You also consent to receive calls and texts, which may be autodialed, from us and our customer communities. Your consent is not a condition to using our service. Please visit our Terms of Use. for information about our privacy practices.
Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
Share a few details and we will match you to trusted home care in your area:
Seniors Helping Seniors of (Mid-Ohio) Lancaster, OH is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Summit Home Care is a skilled and non-skilled home health care agency committed to providing comprehensive health care and comfort and convenience of home. Our mission is to positively impact the quality of life by...
Ray and Lisa are owners of HomeWell Senior Care of Central Ohio. When they discovered that they could own a business that helped seniors age gracefully and with dignity, they knew this was exactly what they wanted to do!...
Our team at Sympatico Healthcare Solutions is composed of qualified and trained professionals who possess the necessary skills and knowledge in providing holistic care. They are dedicated to helping improve the quality of...
At Homewatch CareGivers of Central Ohio East, we are dedicated to providing personalized and compassionate in-home care services for individuals and families in Pickerington and surrounding communities, including...
E&M Home Health Care LLC is a trusted provider of home health care services committed to enhancing the well-being and independence of our clients. With a focus on personalized care and attention to detail, we strive to...
Since 1898, LifeCare Alliance has been there for people facing challenges that stem from medical conditions, disabilities, or aging in place. Each year, LifeCare Alliance serves over 21,000 Central Ohioans in their homes...
FHCS is committed to providing the best possible home health care services. We value our patients, the staff members and everyone that we come in contact with. Taking pride in the health care services that we provide...
Mid Ohio Home Health Care, LLC is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nina's Health Care Services, Llc is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Frontier Health Care Services, Llc is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Watta Kemah Home Health Services, LLC is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Everkind Family Home Care is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nina's Health Care - Franklin is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Twin Angels Home Care LLC is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Pure Home Health LLC we provide:Companionship Care Friendly conversation and emotional support Engaging activities to reduce isolation Personal Care Assistance Bathing, grooming, and hygiene support Dressing and...
PEACE UNITED HEALTHCARE LLC is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Divine Community Care Providers is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
To Comfort and passionate Health Services, we understand that navigating home health care services can be challenging, especially for those new to the concept. Our commitment is to provide a seamless experience by...
The Shepherd's Hands, LLC is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
New Light Home Healthcare, LLC is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Blessed Homecare LLC of OH, located at 1538 Brice Road, Suite B, Reynoldsburg, Ohio 43068, is a home-care provider dedicated to supporting individuals in their own homes with personalized assistance.
Harmony Healthcare Services, LLC is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Tender Nursing Care, Inc is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
100% of patients were assessed for fall risk. 98% received education about their medications. 91% experienced improvement or healing of surgical wounds. 89% showed improvement in mobility and bathing. 76% of...
At Educational Center for the Disables, we provide personalized home health care services to individuals with disabilities. Our team of experienced professionals is dedicated to helping our clients maintain their...
My Voice Residential Services is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Comprehensive Care Solutions by Gihon Care At Gihon Care, we’re dedicated to providing personalized care that meets the unique needs of every individual. Our services support clients in maintaining independence and...
Statnurse Home Health, Inc is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Helping Hands Adapt provides compassionate and reliable home health care services designed to support individuals in maintaining their independence and well-being. Our dedicated caregivers assist with daily activities,...
AISHA MERCY HOUSE LLC is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Signature Care, Inc is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
J&J's Consulting And Home Health, Llc is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CARE GIVERS HOMECARE LLC is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Faithful Hearts Home Health Care LLC is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Visiting Angels of Reynoldsburg, OH is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SCEPTRE HEALTH CARE SERVICES is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Distinguished Orthopedic Home Care is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care Givers Homecare is a home care provider that services in Reynoldsburg, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kean Dillon opened the Senior Helpers Columbus office to provide high quality in-home senior care in the community of Westerville and surrounding areas. Senior Helpers strives to treat clients with the same warmth,...
ComForcare understands that today's busy lifestyles often deprive family members of the time necessary to provide hands on assistance and companionship for their loved ones. Therefore, we want every family we service to...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home somewhere in Buckeye Nation. We service all of Columbus and its surrounding areas, including Marysville...
Our Caregivers Are Handpicked for You Quality Care at Affordable Prices Windsong Senior Home Care understands that no two client needs are the same. That's why after receiving a free in-home assessment, a caregiver...
Helping People through Home Care in Dublin, Ohio - Trusting someone to care for your elderly parent or loved one with disability other than your family, takes a lot of courage and willingness. Turning to FirstLight...
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One of our advisors will contact you soon to connect you with trusted sources for care in your area.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.